BACKGROUND AND OBJECTIVES: Mild cognitive impairment (MCI) is a disorder that usually occurs in the elderly, leading to dementia in some progressive cases. The purpose of this study is to examine the utility of central auditory processing tests as early diagnostic tools for identifying the elderly with MCI. SUBJECTS AND METHODS: This study was conducted on 20 elderly patients with MCI and 20 healthy matched peers. The speech perception ability in a quiet environment and in the presence of background noise and also temporal resolution were assessed by using Speech Perception in Noise (SPIN) and Gap in Noise (GIN) tests, respectively. RESULTS: The results indicated that the ability to understand speech in a quiet environment did not differ significantly between the two groups. However, SPIN at the three signal-tonoise ratios and the temporal resolution scores were significantly different between the two groups (p<0.001). CONCLUSIONS: Individuals with MCI appear to have poorer speech comprehension in noise and a lower temporal resolution than those of the same age, but without cognitive defects. Considering the utility of these tests in identifying cognitive problems, we propose that since the GIN test seems to be less influenced by intervening factors, this test can therefore, be a useful tool for the early screening of elderly people with cognitive problems.
Aged ; Auditory Perceptual Disorders ; Cognition ; Cognition Disorders ; Comprehension ; Dementia ; Humans ; Mass Screening ; Mild Cognitive Impairment ; Noise ; Speech Perception

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the impact of multi-tasking exercise on cognitive and motor function in patients with mild cognitive impairment (MCI) and cognitive normal elderly (CNE).METHODS: A total of 144 subjects were recruited from 14 regional dementia centers in Busan Metropolitan City. With the exception of 77 subjects unsuitable for the study, 67 subjects participated in the intervention. The Korean version of Mini-Mental State Examination for Dementia Screening (MMSE-DS), Subject Memory Complain Questionnaire (SMCQ), and the Korean version of the Short-Form Geriatric Depression Scale (SGDS-K) were used to determine changes in cognitive function and depressive symptoms pre-post intervention in patients with MCI and CNE, respectively. To observe changes in motor function, 5-chair sit to stand and 5-meter walking speed on the lower body strength and walking ability were also measured in both groups.RESULTS: For the MCI group, changes in cognitive and depressive symptoms on the tasks of MMSE-DS (p=0.006), SMCQ (p=0.000), SGDS-K (p=0.000) and the result of the motor function analysis on the items of 5-chair sit to stand (p=0.000), normal speed (p=0.004) and maximal speed (p=0.002) of 5-meter walking speed (p< 0.005). In the CNE group, all the items except MMSE-DS (p=0.068) and SGDS-K (p=0.095) showed statistically significant improvement.CONCLUSIONS: Multi-tasking exercise intervention, including exercise and cognitive tasks, may possibly improve the cognitive and motor function in patients with MCI and CNE.
Aged ; Busan ; Cognition Disorders ; Cognition ; Dementia ; Depression ; Humans ; Mass Screening ; Memory ; Mild Cognitive Impairment ; Walking

Patients with mild cognitive impairment (MCI) are at increased risk of developing dementia and Alzheimer's disease (AD). Currently, no disease-modifying or preventive drugs for AD are available. Non-pharmacological interventions, including cognitive intervention and physical exercise, could assist in the prevention and treatment of AD. Cognitive interventions can improve cognition and prevent dementia, and promote cognitive reserve and plasticity. As there are few standardized intervention programs for the treatment of MCI, development and effective study of cognitive interventions are needed. Psychiatrists should have a great interest in this kind of non-pharmacological interventions regarding neurocognitive disorders.
Alzheimer Disease ; Cognition ; Cognitive Reserve ; Dementia ; Exercise ; Humans ; Mild Cognitive Impairment ; Neurocognitive Disorders ; Plastics ; Psychiatry

OBJECTIVE: We assessed the cumulative conversion rates (CCR) from minor cognitive impairment (MCI) to dementia among individuals who failed to participate in annual screening for dementia. Additionally, we analyzed the reasons for failing to receive follow-up screening in order to develop better strategies for improving follow-up screening rates. METHODS: We contacted MCI patients who had not visited the Dongdaemun-gu Center for Dementia for annual screening during the year following their registration. We compared the CCR from MCI to dementia in the following two groups: subjects registered as having MCI in the Dongdaemun-gu Center for Dementia database and subjects who failed to revisit the center, but who participated in a screening test for dementia after being contacted. The latter participants completed a questionnaire asking reasons for not previously visiting for follow-up screening. RESULTS: The final diagnoses of the 188 subjects who revisited the center only after contact were 19.1% normal, 64.9% MCI and 16.0% dementia. The final diagnoses of the 449 subjects in the Dongdaemun-gu Center for Dementia database were 25.6% normal, 46.1% MCI and 28.3% dementia. The CCR of the revisit-after-contact group was much lower than anticipated. The leading cause for noncompliance was “no need for tests” at 28.2%, followed by “other reasons” at 23.9%, and “I forgot the appointment date” at 19.7%. CONCLUSION: Considering the low dementia detection rate of the group who revisited only after contact and the reasons they gave for noncompliance, there appears to be a need for ongoing outreach and education regarding the course and prognosis of MCI.
Cognition Disorders ; Dementia ; Diagnosis ; Education ; Follow-Up Studies ; Humans ; Mass Screening* ; Mild Cognitive Impairment* ; Prognosis

Diagnostic guidelines for the preclinical, mild cognitive impairment, and dementia stages of Alzheimer's disease (AD) were released by the National Institute on Aging and Alzheimer's Association (NIA-AA) in 2011. Promoted by the subsequent scientific progress, a unifying update, the ‘NIA-AA Research Framework', was published in 2018. This new research framework shifts the definition of AD from syndrome to biological construct based on biomarkers in living people. The biomarkers were grouped into β amyloid deposition (A), pathologic tau (T), and neurodegeneration (N) related, termed the ‘AT(N) classification system#x2019;, which could be extended with new biomarkers as they become available in the future. For the staging of cognitive impairment, three syndromal stages for observational studies and six numeric stages for clinical trials were also suggested. This biomarker-based classification combined with clinical staging is expected to enhance the understanding of AD as well as aid in precise targeting for interventional clinical trials. This review focused on the introduction of the new 2018 NIA-AA Research Framework. Although this framework has been proposed for research purposes, it is expected to be adopted into general clinical practice with thorough examination and validation in the future.
Alzheimer Disease ; Biomarkers ; Classification ; Cognition Disorders ; Dementia ; Mild Cognitive Impairment ; National Institute on Aging (U.S.) ; Plaque, Amyloid

PURPOSE: The aim of this study is to examine the reciprocal causal relationship between social activities and health with reference to the cognitive function level among community-dwelling older adults. METHODS: We conducted a longitudinal data analysis using the 4(th) (Time 1) and 5(th) (Time 2) waves from the Korean Longitudinal Study of Ageing adopting cross-lagged panel analysis (CLPA). RESULTS: A total of 3,473 community-dwelling older adults were included in the analysis: 2,053 in the normal cognitive function group, 912 in the mild cognitive impairment group, and 508 in the moderate to severe cognitive impairment group. The CLPA revealed that higher levels of social activities at Time 1 significantly influenced better subjective health perception at Time 2 in all three groups. In addition, better subjective health perception at Time 1 significantly influenced higher levels of social activities at time 2 only in the normal cognitive function group. CONCLUSION: This study demonstrates that participating in social activities has positive effects on health regardless of the cognitive function level in community-dwelling older adults. This finding suggests that there is a need to develop strategies that can be used to encourage older adults with cognitive decline to maintain participation in social activities.
Adult* ; Cognition Disorders ; Cognition* ; Diagnostic Self Evaluation ; Humans ; Longitudinal Studies ; Mild Cognitive Impairment ; Social Participation ; Statistics as Topic

PURPOSE: The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer. METHODS: A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis. RESULTS: CRCI was directly affected by cancer symptoms (β=.19, p=.004) and fatigue (β=.56, p<.001)(R²=47.2%). Depression was directly affected by fatigue (β=.48, p<.001) and CRCI (β=.27, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI. CONCLUSION: Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.
Anxiety ; Chronic Disease ; Cognition ; Cognition Disorders* ; Depression* ; Drug Therapy ; Fatigue* ; Gastrointestinal Neoplasms* ; Humans ; Mild Cognitive Impairment ; Negotiating

OBJECTIVE: To explore whether the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) can be used to screen for dementia or mild cognitive impairment (MCI) in less educated patients with Parkinson's disease (PD). METHODS: We reviewed the medical records of PD patients who had taken the Korean MMSE (K-MMSE), Korean MoCA (K-MoCA), and comprehensive neuropsychological tests. Predictive values of the K-MMSE and K-MoCA for dementia or MCI were analyzed in groups divided by educational level. RESULTS: The discriminative powers of the K-MMSE and K-MoCA were excellent [area under the curve (AUC) 0.86–0.97] for detecting dementia but not for detecting MCI (AUC 0.64–0.85). The optimal screening cutoff values of both tests increased with educational level for dementia (K-MMSE < 15 for illiterate, < 20 for 0.5–3 years of education, < 23 for 4–6 years, < 25 for 7–9 years, and < 26 for 10 years or more; K-MoCA < 7 for illiterate, < 13 for 0.5–3 years, < 16 for 4–6 years, < 19 for 7–9 years, < 20 for 10 years or more) and MCI (K-MMSE < 19 for illiterate, < 26 for 0.5–3 years, < 27 for 4–6 years, < 28 for 7–9 years, and < 29 for 10 years or more; K-MoCA < 13 for illiterate, < 21 for 0.5–3 years, < 23 for 4–6 years, < 25 for 7–9 years, < 26 for 10 years or more). CONCLUSION: Both MMSE and MoCA can be used to screen for dementia in patients with PD, regardless of educational level; however, neither test is sufficient to discriminate MCI from normal cognition without additional information.
Cognition ; Cognition Disorders* ; Dementia ; Education ; Humans ; Mass Screening* ; Medical Records ; Methylenebis(chloroaniline)* ; Mild Cognitive Impairment ; Neuropsychological Tests ; Parkinson Disease*

OBJECTIVES: This study analyzed the differences of body mass index(BMI) in Korean patients with Alzheimer's diseases(AD), Mild Cognitive Impairment(MCI), and healthy controls to verify whether low BMI is associated with cognitive impairment. Furthermore, this study also sought to examine any association between BMI and Mini Mental State Examination-Korean version(MMSE-K), Clinical Dementia Rating(CDR), and Global Deterioration Scale(GDS). METHODS: A total of 257 subjects were included in the study. History taking, mental status examination, physical examination and neurocognitive function test were carried out for the diagnosis of AD and MCI. The subjects' demographic data and presence of diseases were also surveyed. The overall cognitive function and severity of diseases were assessed using MMSE-K, GDS, and CDR. RESULTS: The order of BMI was found to be healthy controls>MCI>AD, with statistically significant differences among the groups. The order of MMSE-K scores was similar, with healthy controls>MCI>AD in statistically significant differences. The healthy controls had the lowest CDR and GDS scores, and AD patients had the highest scores. There was a significant positive correlation between BMI and MMSE scores(r=0.238, p=0.000). BMI was negatively correlated with CDR(r=−0.174, p=0.008) as well as with GDS(r=−0.233, p=0.000). CONCLUSIONS: Measuring BMI of patients with AD or MCI is expected to be meaningful in that BMI could be a clinical indicator of AD. We expect this to be beneficial for the diagnosis, prevention, and therapeutic approach of AD and also expect large-scale, long-term longitudinal studies to follow.
Alzheimer Disease* ; Body Mass Index* ; Cognition Disorders ; Cognition* ; Dementia ; Diagnosis ; Humans ; Longitudinal Studies ; Mild Cognitive Impairment* ; Physical Examination

The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer’s disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.
Activities of Daily Living ; Cognition ; Cognition Disorders ; Consensus ; Dementia ; Epidemiologic Studies ; Mild Cognitive Impairment ; Trail Making Test ; Verbal Learning